Prenatal Maternal Stress and the Risk of Lifetime Wheeze in Young Offspring: An Examination by Stressor and Maternal Eth
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ORIGINAL PAPER
Prenatal Maternal Stress and the Risk of Lifetime Wheeze in Young Offspring: An Examination by Stressor and Maternal Ethnicity Gretchen Bandoli1 • Ondine von Ehrenstein2 • Jo Kay C. Ghosh3 Marie E. S. Flores4 • Christine Dunkel Schetter5 • Beate Ritz1
•
Ó Springer Science+Business Media New York 2015
Abstract Prenatal psychosocial stressors may increase the risk of wheeze in young offspring, yet little attention has been given to the effects that maternal ethnicity may have on this relationship. From a population-based cohort of 1193 children, we assessed the effect of maternal prenatal stressors on the risk of lifetime wheeze in young offspring. We further studied whether maternal Latina ethnicity modified these associations. The risk of wheeze in the offspring was increased from high levels of pregnancy anxiety (aRR 1.40, 95 % CI 1.07, 1.83), negative life events (aRR 1.36, 95 % CI 1.06, 1.75), or low paternal support (aRR 1.41, 95 % CI 1.02, 1.96). The risk of lifetime wheeze was stronger in the offspring of Latina mothers than of White mothers for these same stressors. Multiple maternal prenatal stressors are associated with increased risk of lifetime wheeze in young offspring, with slight effect modification by Latina ethnicity.
Keywords Prenatal stress Childhood wheeze Latina ethnicity Fetal programming
Background Recently, several studies have investigated the contributions of prenatal psychosocial stressors to the occurrence of respiratory illness in the offspring [1–7]. This hypothesis is part of the phenomenon known as ‘‘fetal programming,’’ which postulates that during critical periods of fetal development, certain stimuli or insults can have lifelong and even trans-generational effects [8]. Maternal prenatal stress may alter the maturation of the fetal immune system, potentially shifting the balance towards a Th2-response that has been related to atopic disease, such as asthma. Additionally, the developing hypothalamus–pituitary– adrenal (HPA) axis may be affected by maternal stress mediated through excess placental secretion of corticotrophin releasing hormone (CRH), potentially influencing the developing fetal immune system [9, 10].
& Gretchen Bandoli [email protected] 1
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Box 951772, Los Angeles, CA 90095, USA
2
Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
3
Los Angeles, CA, USA
4
Department of Family and Social Medicine, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, NY, USA
5
Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
Theoretical/Conceptual Framework Different stressors (e.g. chronic, acute, transient) may elicit different physical and emotional responses. Stress exposures, perceptions, and responses may also vary culturally. Ethnic minorities and low-income women tend to report mor
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